Diabetes, asthma and other chronic conditions
Chronic diseases are the leading cause of illness, disability and death in Australia. They have arisen in part because of medicine’s own success in limiting infection and infant deaths during the late 19th and early 20th century; and with changing lifestyles and ageing population, chronic diseases have become increasingly common.
Hence one of our biggest tasks as doctors is to help patients manage these illnesses.
Type 2 Diabetes
The number of people with type 2 diabetes is growing, most likely the result of lifestyle and dietary changes, and an ageing population. Within 20 years, the number of people in Australia with type 2 diabetes is estimated to increase from 870,000 in 2014, to more than 2.5 million.
If left undiagnosed or poorly managed, type 2 diabetes can lead to coronary artery disease, stroke, kidney failure, limb amputations and blindness. The early identification and optimal management of people with type 2 diabetes is therefore critical.
At East Canberra General Practice we adopt a patient centred communication style. This involves assessing a patient’s clinical signs and symptoms, as well as their thoughts, fears, preferences and expectations, and their social context. This ensures a complete understanding of the patient who is living with type 2 diabetes.
In cooperation with our patient, we then develop management plans tailored specifically to his or her needs, values and choices. In particular, we will be looking to find out how diabetes is affecting the patient’s quality of life and the treatments and activities that should have priority.
Asthma involves various respiratory symptoms eg wheeze, shortness of breath, cough and chest tightness. Asthma is common in Australia, with a prevalence of about 10%. Most cases of asthma begin in childhood and adolescent years. However, asthma may occur for the first time at any age. It is commonly overlooked in adults, particularly in those aged 65 years and older. Adult-onset asthma differs from asthma that first occurs in childhood as it is often less well controlled and associated with a faster decline in lung function.
The cause of asthma at any age is unclear but there are a number of risk factors for the development of adult-onset asthma. These include exposure to irritant substances, obesity, pharmaceuticals, rhinitis, environmental pollutants, respiratory tract infections and psychological stress. In Australia about 10% of adult-onset asthma cases are caused by occupational exposures. In fact 20–25% of adults with asthma report that their symptoms are worse at work.
In managing asthma in adults we confirm the diagnosis, assess the symptoms and their control, provide asthma education about the underlying nature of the condition and establish treatment goals. In doing so, we enquire about the patient’s expectations, provide advice about asthma self-management and develop a written asthma action plan.
Good asthma symptom control is achievable for most patients with the use of medication. We will recommend medications suited to the particular needs of the patient.